Blepharitis Caused by Demodex

Objective: Demodicosis is a Skin disease in humans caused by Demodex folliculorum (D. folliculorum) and Demodex brevis (D.brevis) mites. Demodex infestation is mostly located in sebaceous and meibomian glands in the hair follicles. The aim of this study was to determine the age and sex distribution of Demodex infestation in patients with blepharitis. Methods: Between 2011-2018, eyelashes from 335 patients with blepharitis, visual impairment or conjunctivitis attached to the cellophane tape were sent to the laboratory of Department of Medical Parasitology in Çukurova University Medical Faculty and were examined within 1 hour. Results: D. folliculorum was detected in 143 (42.6%) of the 335 patients. Of the patients in whom D. folliculorum was detected, 50 (35%) were female and 93 (65%) were male. The mean age of patients with D. folliculorum was 64.1 years and the mean age of patients without D. folliculorum was 52.7 years. Conclusion: In patients with blepharitis, the incidence of Demodex increases with age.

Immune mechanisms in human and canine demodicosis: A review.

Demodex mites are saprophytic parasites of the mammalian skin, mostly found in or near pilosebaceous units of hairy regions. While they can be found in healthy humans and animals without causing any clinical manifestations, they were suggested to create pathogenic symptoms when they appear in high densities under favourable conditions (ie, demodicosis). Nevertheless, their role as the primary causative agent of the pathogenic conditions in humans is debated today. Canine demodicosis, which is highly prevalent in certain dog breeds, provides a valuable tool for studying the pathogenesis of human demodicosis. Canine and human demodicosis are caused by different Demodex species, and the clinical manifestations in former could be life-threatening. Nevertheless, current literature suggests similar immune responses and immune evasion mechanisms in human and canine demodicosis; cellular immunity appeared to have a central role in protection against demodicosis, and Demodex mites were shown to influence both innate and adaptive immune response to escape immune attack. The aim of this review is to summarize the relevant literature on demodicosis obtained from studies conducted on both organisms, and draw the attention to the effect of mite-associated factors (eg, microbiota) on the different clinical manifestations displayed during human and canine demodicosis.

Establishing an RNA extraction method from a small number of Demodex mites for transcriptome sequencing.

Demodex is a type of parasitic mite which could cause serious dermatoses in 11 orders of mammals. However, due to the tiny body with thick chitin hard to be ruptured as well as the difficulty in obtaining a large number of mites, the quantity and quality of extracted RNA could hardly satisfied for transcriptome sequencing. This has hampered the research on functional genes and molecular pathogenesis of Demodex for a long time. To solve the problems above, the present study established a new RNA extraction method in combination Azanno method with liquid nitrogen grinding using 16 human and canine Demodex mite samples. The RNA quality detection results of Agilent 2100 Bioanalyzer showed that 8 of 16 RNA samples met the requirements for trace RNA-Seq, with RIN of 5.0-6.5 and RNA quantity of 1.1-16.0 ng. RNA quality was affected by grinding process and parasitic position of Demodex. Enough grinding number (≥2000) in moderate time (≤20 min) was significant for mites' complete rupture and RNA degradation prevention. D. brevis (100%, 3/3) parasitizing in human sebaceous glands had significantly higher RNA qualification rate than D. folliculorum (57.14%, 4/7) parasitizing in human hair follicles. Yet D. canis parasitizing in dog had lower RNA qualification rate (16.67%, 1/6) as mites were embedded in skin tissues and blood clots. It should be pointed out that microplate reader had defects with a lower RNA qualification rate of 6.25% (1/16) unmatched with 2100 Bioanalyzer, reminding that it could be only used as reference in RNA quality evaluation.

Attraction of Culex pipiens to uropygial gland secretions does not explain feeding preference for American robins.

Culex pipiens, the endemic mosquito vector of West Nile virus in eastern North America, is responsible for maintenance of the virus in avian reservoir hosts, the most important of which appears to be the American robin. One reason for the greater involvement of robins is believed to be the feeding preference of Cx. pipiens, however, the basis of this preference is not understood. We tested the hypothesis that the species-specific chemical profile of avian uropygial gland secretions are used by Cx. pipiens as cues to locate birds and, therefore, may contribute to the observed feeding preferences. We used gas chromatography-mass spectrometry to identify the semi-volatile components of the uropygial gland secretions of American robins and two other common reservoir host species, the house sparrow and European starling. We found that the chemical composition of the robin secretions was different from those of the sparrows and starlings. Through behavioral choice trials conducted in a dual-port olfactometer, we also found that Cx. pipiens did not prefer the secretions of robins over the other two species. Surprisingly, however, we found that Cx pipiens were more often attracted to live starlings over robins and to the secretions of starlings over those of robins.

Demodex mites modulate sebocyte immune reaction: possible role in the pathogenesis of rosacea.

BACKGROUND: Rosacea is a common facial skin disorder mainly affecting middle-aged adults. Its aetiology is unknown and pathogenesis uncertain. Activation of the host innate immune response has been identified as an important factor. The Demodex mite population in the skin of rosacea patients is significantly higher than in patients with normal skin, suggesting that they may be of aetiological importance in this disorder. OBJECTIVES: To determine the potential of Demodex mites to interact with the host immune system. METHODS: Live Demodex mites were extracted from normal facial skin of control subjects and used in cell stimulation experiments with the immortalized SZ95 sebocyte line. Time- and mite-dose-dependent experiments were performed. Direct effects of Demodex and effects of the medium in which Demodex had been cultured were evaluated on the Toll-like receptor (TLR) signalling pathway on both a gene and protein expression level. RESULTS: Mites modulated TLR signalling events on both mRNA and protein levels in SZ95 sebocytes. An initial trend towards downmodulation of genes in this pathway was observed. A subsequent switch to positive gene upregulation was recorded after 48 h of coculture. Demodex secreted bioactive molecules that affected TLR2 receptor expression by sebocytes. High numbers of Demodex induced proinflammatory cytokine secretion, whereas lower numbers did not. CONCLUSIONS: Demodex mites have the capacity to modulate the TLR signalling pathway of an immortalized human sebocyte line. Mites have the capacity to secrete bioactive molecules that affect the immune reactivity of sebocytes. Increasing mite numbers influenced interleukin-8 secretion by these cells.

Neutrophilic sebaceous adenitis with intralobular Demodex mites: a case report and review of the literature.

A 61-year-old white man presented with a 1-week history of an asymptomatic erythematous, annular plaque with minimal scale limited to the nasal bridge. Histological examination showed a mixed infiltrate of lymphocytes and neutrophils within sebaceous glands. The clinical and histopathological presentation was consistent with a diagnosis of neutrophilic sebaceous adenitis. Several Demodex brevis mites were present deep within the affected sebaceous lobules. Demodex brevis mites are uncommon inhabitants of sebaceous glands of the nose, presenting more commonly on other body sites. The cause of neutrophilic sebaceous adenitis is unknown, but the presence of D. brevis in affected sebaceous glands in this case suggests a possible association.

Ubiquity and diversity of human-associated Demodex mites.

Demodex mites are a group of hair follicle and sebaceous gland-dwelling species. The species of these mites found on humans are arguably the animals with which we have the most intimate interactions. Yet, their prevalence and diversity have been poorly explored. Here we use a new molecular method to assess the occurrence of Demodex mites on humans. In addition, we use the 18S rRNA gene (18S rDNA) to assess the genetic diversity and evolutionary history of Demodex lineages. Within our samples, 100% of people over 18 years of age appear to host at least one Demodex species, suggesting that Demodex mites may be universal associates of adult humans. A phylogenetic analysis of 18S rDNA reveals intraspecific structure within one of the two named human-associated Demodex species, D. brevis. The D. brevis clade is geographically structured, suggesting that new lineages are likely to be discovered as humans from additional geographic regions are sampled.

Environmental scanning electron microscopy observation of the ultrastructure of Demodex.

In this study, numbers of Demodex of hair follicles and sebaceous glands were prepared and the ultrastructure (especially the mouthparts) of Demodex was observed firstly with environmental scanning electron microscopy (ESEM). The most suitable treatment methods and optimal environmental condition for observing the genus samples were found. The samples were washed with detergent and rinsed with distilled water, and then were taken to the specimen stage, on which there was carbon adhesive tape, using special tools. When the temperature was at 5 degrees C and chamber pressure at 5 mbar respectively, the surface of the samples could be fully imaged without covering water or dehydration. The sample surfaces were plump and clear without postmortem changes and charging artifacts. Detailed information about each part of Demodex was observed by ESEM, and clear three-dimensional images were recorded. The mouthparts of D. folliculorum were composed of a complex set of structures, which included a round oral opening, a sharp oral needle, and a special hypostome that looked like a longitudinal spindle in the central position. On the end segment of palpus, there were seven strong palpal claws located on each side of the mouthparts. D. folliculorum had special piercing mouthparts, while the mouthparts of D. brevis were a simpler structure. We could not observe the oral needle of D. brevis, and there were only five pairs of palpal claws on the end segment of palpus. The offensive organs of Demodex resulted in its pathogenic effects. After studying hundreds of Demodex, we identified both female and male species of D. folliculorum, but only females of D. brevis in our sample.

Deposition of IgD, alpha-1-antitrypsin and alpha-1-antichymotrypsin on Demodex folliculorum and D. brevis infesting the pilosebaceous unit.

A total of seven routinely processed biopsy specimens of facial skin lesions with infestation of Demodex folliculorum or D. brevis were immunostained for plasma proteins and secretory proteins. The cuticular layer of the mites located within the pilosebaceous unit was selectively immunoreactive for IgD (delta chain), alpha-1-antitrypsin and alpha-1-antichymotrypsin. Negative results were obtained for IgG, IgA, IgM, IgE, albumin, fibrinogen, C3, amyloid P component, prealbumin, lysozyme and lactoferrin. These findings suggest a novel function of IgD and serum protease inhibitors as a protective host response to the mite.

Larva migrans within scalp sebaceous gland.

A case of larva migrans or serpiginous linear dermatitis on the scalp of a teenager is reported. An ancylostomid larva was found within a sebaceous gland acinus. The unusual skin site for larva migrans as well as the penetration through the sebaceous gland are highlighted. The probable mechanism by which the parasite reached the skin adnexa is discussed.

Demodex sp. in California ground squirrels.

An undescribed species of Demodex (Acari: Demodecidae) was observed in hair follicles and ducts of sebaceous glands in the ear canals of seven California ground squirrels (Spermophilus beecheyi) from Santa Clara County, California (USA). The animals had died of unrelated causes and were submitted for necropsy between September 1994 and February 1996. Similar mites were observed in the lumens of hair follicles and ducts of Meibomian glands in the eyelids of two of these squirrels. Microscopic changes in the epithelium and surrounding dermis, when present, were minimal. No associated clinical signs of disease or macroscopic lesions were observed. To our knowledge, this is the first report of Demodex sp. in a ground squirrel.

Three species of the hair follicle mites (Acari: Demodicidae) parasitizing the sheep, Ovis aries L.

Evidence of three distinct Demodex species parasitizing the sheep is given for the first time. A newly distinguished Demodex sp. is described, and diagnostic characters are compared for Demodex ovis Hirst, 1919, D. aries Desch, 1983, and Demodex sp. Information on prevalence, distribution in the tissues, and pathogenicity of these three Demodex species in 132 head of sheep in Czechoslovakia is presented, with a review of such data published to date.

Demodex flagellurus sp. n. (Acari: Demodicidae) from the preputial and clitoral glands of the house mouse, Mus musculus L.

An extremely large new demodicid, Demodex flagellurus sp. n., is described in all stages of its life cycle from the house mouse, Mus musculus L. Its habitat, the preputial and clitoral glands, is reported as new for demodicid mites. Adaptations to habitat, host transfer, and the potential of this species as a useful model in experimental studies on demodicid biology are discussed.

The prevalence of hair follicle mites in caucasian New Zealanders.

Seventeen of 88 persons examined were positive for hair follicle mites of the genus Demodex, with eight having single species infestation of D. brevis, seven having D. folliculorum, and two persons being infested with both species. Prevalence increased from 8 percent to 75 percent according to age group. There was no correlation of infestation with host sex skin type, hygiene, use of cosmetics, or exposure to sun or other UV light. Demodex infestations in caucasian New Zealanders are similar to those reported from northern hemisphere countries.

Skin penetration of infective hookworm larvae. I. The path of migration of infective larvae of Ancylostoma braziliense in canine skin.

Migratory behaviour of Ancylostoma braziliense was studied in relation to the structure of the skin in dogs after primary infections. Data were obtained studying serial sections of lateral skin areas 6 mm in diameter, which had been exposed to larvae. The sections were stained either with Harris' haematoxylin and eosin or with P.A.S. or as outlined by Crossmon. Most of the larvae managed to penetrate the skin within 1/2 hr after the application. Hairs did not seem to constitute sites of entry. The larvae moved into the horny layer where edges of keratinized cells provide uneven spots. They migrated approximately parallel to the surface from the horny layer into the living epidermis and continued into an external root sheath of a hair follicle. They could only leave this site via sebaceous glands for the dermis or via apocrine sweat glands for the hypodermis. Tunnels from the epidermis into the dermis, however, suggested that a direct trans-epidermal migration had occurred. The vessels invaded by larvae were hypodermal lymphatic vessels. The first ones were found in these structures 1/2 h after the onset of the exposure.